Endometriosis Treatment Options and Management

Treatments are individualized and based on several key factors including the severity of symptoms, the patient's age, whether they wish to become pregnant, and their personal preferences.

From less to more invasive and efficacy, common options include pain medication, hormone therapy, and surgical intervention. Some people also explore alternative or complementary therapies.

Currently, there is no definitive cure for endometriosis before menopause. Thus, treatment mainly focuses on managing symptoms, slowing the disease's progression, and improving quality of life.

Your healthcare provider will help you weigh the options by considering your symptoms, overall health, and goals. For example, if you want to get pregnant, some hormonal therapies will not be appropriate because are mainly contraceptive. On the other hand, women with severe alteration of quality of life and complete motherhood, Raga removal, including hysterectomy can be considered a definitive option of treatment.

With medical therapies, symptoms often return after treatment is stopped.

While surgery can offer long-term relief, recurrence is possible and depends on the thoroughness of the procedure. For many, progesterone- based hormonal treatments are continued after surgery to reduce the risk of recurrence.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are often used for pain and to reduce inflammation. For more severe pain, a doctor may prescribe stronger medication, including morphine 

If pain continues, you may be referred to a pain management specialist who can offer other treatments, such as working with a physiotherapist or psychologist. 

By suppressing or stopping the menstrual cycle, hormonal treatments can slow the growth of endometrial-like tissue and relieve pain.

Options include:

Continuous combined hormonal contraceptives (pills, patches, or vaginal rings).

Progestins only pills (e.g., orally or hormonal intrauterine device).

GnRH (Gonadotropin-releasing hormone) analogues.

Aromatase inhibitors.

Side effects can be related to low estrogen levels and may include headaches, irregular bleeding, weight gain, fatigue, and hot flashes. The specific effects vary depending on the treatment and the individual. 

No. Surgery is considered a second-line treatment, typically for those with severe pain, infertility, or cases where the disease affects other organs such as big ovarian cysts 

Excision surgery (cutting out the lesions) is considered the gold standard for long-term symptom relief. Ablation (burning the surface) is sometimes performed by less experienced surgeons but is less effective.

No. Endometriosis is defined as tissue growth outside the uterus. While a hysterectomy removes the uterus, it does not remove all the extrauterine lesions and does not guarantee complete pain relief. 

Therefore, in women with severe impairment in quality of life, if the hysterectomy is performed, it is also very important to remove all perennial implant shown at the time of the surgery.

No, achieve the best quality of care, it highly relevant that surgical treatment are performed by well-trained gynecological surgeons in highly complex surgical procedure, including minimally invasive, laparoscopic or robotic approaches

Yes, many women with endometriosis can get pregnant, but 30–40% may experience difficulty.

Age and ovarian cysts are common reason. Surgery to remove lesions and adhesions may improve fertility outcomes. For some women, in vitro fertilization technique can be an option to achieve pregnancy.

No. While symptoms may significantly improve during pregnancy for some, they typically return after giving birth and stopping breastfeeding.

Combining lifestyle changes like regular exercise, stress management, and dietary modifications with medical treatment is safe and can enhance effectiveness.

The timeline for improvement varies, but many treatments begin to show results within three to six months. 

Normally, surgical treatment is after six months of permanent treatment without benefits

Follow-up frequency depends on your individual condition and how you respond to treatment, but, if the symptoms improve, check-ups are often scheduled every 6 to 12 months.